Despite the fact that surveillance is a well-recognized public health tool, the capability for cancer surveillance in the U.S. is limited. A more robust U.. cancer screening surveillance system would capture data on cancer screening utilization that was linked with: outcome data from cancer registries, patient demographic and risk factor information, and electronic health records of use to patients and providers. This project will assess the feasibility and utility of implementing a national screening surveillance system for screening-amenable cancers (cervical, breast and colorectal cancer). An environmental scan to identify screening programs (both cancer and non-cancer) will be conducted to guide the process of inquiry. In keeping with the CDC's Framework for Evaluation, stakeholders will play a key role in this formative evaluation project. Stakeholders will represent various entities who would be involved in the planning (directors of state chronic disease and prevention services departments), development (health informatics, electronic health record vendors), data collection (screening providers, primary care providers) and/or end-use (providers, insurers, public health professionals, researchers) of a screening surveillance system. Mixed methods will be used to gather data from up to 150 stakeholders through key informant interviews, focus groups, and a modified Delphi process for expert consensus. The credibility and utility of this information will be supported through input from an Advisory Board, representing key stakeholder groups. Information gleaned from this assessment will result in recommendations for implementing a national cancer screening surveillance system, which will be disseminated not only in a peer-reviewed publication but channels recommended by stakeholders. Assuring that the recommendations incorporate viewpoints from diverse stakeholders, as proposed for this project, will increase the likelihood that a national system will be implemented and will maximize its utility and long-term sustainability.